Palliative Care Nursing Assistant Training Project

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Palliative Care Nursing Assistant Training Project

• National Association of State Veterans Homes
  Summer Conference
• August 18, 2009
• Kelly Schneider, RN, BSN
• [phone]
• Kelly.Schnieder2_at_va.gov

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Complete this questionnaire . . .
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. . . and receive both booklets!
10 value!
10 value!
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. . . and enter a drawing to win one of 5 CDs!
100 value!
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HPC Mission

• Honor Veterans preferences at end-of-life
• Enrolled Veterans in VA facilities
• Enrolled Veterans in the community
• Veterans eligible for enrollment but not yet
  enrolled

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The Imperative

• State Veterans Homes
• 24,000 nursing home beds
• 6,000 deaths annually
• 25 average annual mortality rate
• VA
• 23,000 inpatient deaths
• 3,400 deaths in nursing home beds (15 of all
  deaths)
• 6,250 deaths in hospice beds (27 of all deaths)

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Comprehensive End-of-life Care Initiative (CELC)

• Improve access to hospice and palliative care in
  all settings
• Build a sustainable HPC infrastructure
• Implement quality measures and disseminate
  successful practices
• Increase expertise -PC Nursing Assistant Training
• Evaluate and monitor effectiveness and
  sustainability of initiative

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PC Nursing Assistant TrainingHospice and
Palliative Nurses Association

• Train VA and State Veterans Home staff
• Palliative care training for nurse educators
• Training materials
• On-going follow-up and mentoring for nurse
  educators to implement training programs in their
  facilities
• Develop Curriculum
• Modify EPEC for Veterans for Nursing Assistants
• Create CDs and online access for distance
  learning

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Palliative Care Nursing AssistantTrain-the-Traine
r Program

• Focus
• Nursing assistants working with Veterans in need
  of palliative care
• Modules
• Communication
• Pain Management
• Symptom Management
• Care of the Patient and Family When Death is
  Nearing
• Taught by nurses who attend a Train-the-Trainer
  program

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PCNATrain-the-Trainer Program

• Part of the VA Comprehensive End-of-Life Care
  Initiative
• Dynamic interactive program to prepare nurse
  educators to teach palliative care to nursing
  assistants
• Target audience - VA and State Veterans Home
  staff
• Includes palliative care content and facilitation
  techniques to teach nursing assistants

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Participants receive

• 2 year HPNA membership
• HPNA Approved Educator status
• 11 CEUs
• Training materials
• Facilitator Guide / four nursing assistant
  modules / CD with slides and speaker notes
• Learning activities

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Participants receive

• HPNA Core Curriculum
• Statement on the Scope and Standards
• Hospice and Palliative Nursing Assistant
  Competencies
• Conversations in Palliative Care

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PCNA Train-the-Trainer Programs

• Each facility reports on their teaching efforts
• At one month, then every 3 months
• Participants receive a monthly case study
  education via listserv
• Networking opportunity with other professionals
  that care for the veteran population
• Identify and plan strategies to manage challenges
  faced by educators

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Why is this important?

• Palliative care is initiated much sooner than
  hospice care and the condition may improve after
  care is initiated
• Hospice agencies dont cover hospice care 24/7
• Empowers the nursing assistant to identify and
  report unique issues related to end of life care

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Why is this important?

• Allows the nursing assistant the opportunity to
  understand and provide creative means of support
  to veteran and family members
• The care is cost effective

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PCNA Train-the-Trainer Programs

• Oct 28 - 29, 2008 Hollidaysburg, PA
• 48 attended
• of facilities represented
• VA 13
• SVH 5

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PCNA Train-the-Trainer Programs

• January 28 - 29, 2009 Las Vegas, NV
• 55 attended
• of facilities represented
• VA 17
• SVH 1

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PCNA Train-the-Trainer Programs

• March 3 - 4, 2009 Alexandria, VA
• 35 attended
• of facilities represented
• VA 13
• SVH 1

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PCNA Train-the-Trainer Programs

• April 29 - 30, 2009 Atlanta, GA
• 76 attended
• of facilities represented
• VA 37
• SVH 1

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PCNA Train-the-Trainer Programs

• June 17 - 18, 2009 St. Louis, MO
• 85 attended
• of facilities represented
• VA 38
• SVH 10

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PCNA Train-the-Trainer Programs

• July 29 - 30, 2009 Boston, MA
• 65 attended
• of facilities represented
• VA 26
• SVH 3

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Accomplishments

• Out of 136 VA SVH facilities attending the
  training 34 have submitted reports
• Number of nursing assistants who have attended
  training so far
• VA 297
• SVH 71

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PCNA Train-the-Trainer Programs

• 2009-2010 Next steps
• Continued Train-the-Trainer program across the
  country
• Locations?
• Teleconference Web course Program starting in
  January
• SVH participation?

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Comments from facilities

• This is now a part of our annual training for
  nursing assistants
• Our nursing assistants are very pleased with the
  program and that they are singled out to receive
  it
• One of the nursing assistants saw the need to
  develop a hospitality cart for the veteran and
  his family during his last days of life, we
  thought voluntary services did this!

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Questions?